Reuters Health

Sunday, September 8, 2002

By Charnicia E. Huggins

NEW YORK (Reuters Health) - Eleven-year-olds who were born weighing less than normal are more likely to have psychiatric and behavioral disorders--attention problems in particular--than their normal birth weight peers, according to a team of Norwegian researchers.

They hypothesize that the children's inattention may lead to their behavior problems and resulting lack of social skills, or difficulty relating with their peers, both of which have been previously reported.

To investigate, Dr. I. Elgen from the University of Bergen in Norway and her colleagues studied 130 11-year-olds who, at birth, weighed less than 2,000 grams (4.4 pounds). Their study also included 131 normal birth weight children for comparison.

Nearly 30% of the low birth weight children had psychiatric disorders, most commonly attention-deficit/hyperactivity disorder (ADHD). These types of problems were reported three times more often among low birth weight children than among their normal birth weight peers, the researchers report in the September issue of the journal Archives of Disease in Childhood: Fetal and Neonatal Edition. Other psychiatric disorders included depression, separation anxiety and some type of phobia.

Furthermore, 4 in 10 low birth weight children had behavioral problems, in comparison to less than 10% of their normal birth weight peers, study findings indicate. In fact, the low birth weight children were eight times more likely to have behavioral problems than their peers.

"The amount of behavioral problems are much higher than psychiatric disorders, meaning that even though a low birth weight child does not have a disorder, they might suffer from behavioral problems that have to be taken care of," Elgen told Reuters Health in an interview.

Behavior problems included inattention and social problems--which were strongly linked and were reported by both mothers and teachers--as well as anxiety problems and delinquency problems, the report indicates. Low birth weight children were also more likely to have low self-esteem.

The link between the children's social problems and their attention problems--in terms of them being easily distracted, impulsive and unable to adapt easily--suggests that inattention may be the root of the problem among low birth weight children, the researchers speculate.

"Possibly having difficulties with adaptability, impulsivity, and sustaining attention is the cause of difficulties in relating to peers and the cause of lower self-esteem and lower social activity level in the present study," Elgen and colleagues write.

Commenting on the study, Dr. Joan Kinlan, a Washington, DC-based private practice child and adolescent psychiatrist, said, "There appears to be a slightly higher incidence of behavioral and psychiatric disorders, but the majority of these is ADHD, which may be coincidental and is highly treatable."

The ADHD-related finding may be coincidental because the condition may be genetic and Elgen's study provided little background information about the mothers of the low birth weight children, Kinlan explained.

Since there was a "slight association," however, parents with concerns about their child's behavioral or psychiatric state should have them evaluated by a trained professional, she said.

Most of all, "enjoy your child," Kinlan advises parents. "Most of them catch up (to their peers) by age 5, and for those that do have problems, they are highly treatable."

The Norwegian Foundation for Health and Rehabilitation and the Norwegian Research Council funded the study.